Imada T, Rino Y, Takahashi M, Suzuki M, Tanaka J, Shiozawa M, Kabara K, Hatori S, Ito H, Yamamoto Y, Amano T
First Department of Surgery, Yokohama City University, School of Medicine, Japan.
Surgery. 1998 Feb;123(2):165-70.
Malnutrition, gallbladder dysfunction, dumping syndrome, reflux esophagitis, and gastritis of the remnant stomach are unfavorable sequelae in patients undergoing gastrectomy. Operative procedures should be improved to ensure such patients a satisfactory quality of life.
After operation, gallbladder function, reflux gastritis, gastric emptying, and caloric intake were evaluated in 20 patients with early gastric cancer undergoing pylorus-preserving gastrectomy (PPG) and 25 patients undergoing conventional distal gastrectomy (CDG).
The resting gallbladder area increased significantly after CDG. In contrast, after PPG the gallbladder area showed no significant change and the contraction rate decreased slightly. After CDG, emptying was much more rapid for the first 30 minutes after ingestion of a meal. Although delayed emptying was observed early after PPG, the rate of emptying increased with time. Gastric pH was lower and gastric mucosal injury was milder in patients undergoing PPG. These results are attributed to preserved pyloric function. The caloric intake and changes in body weight after operation were similar in both the CDG and PPG groups.
PPG has advantages over CDG in terms of gallbladder function, the condition of the remnant stomach, and gastric emptying, PPG should be used in carefully selected patients with early gastric cancer to improve their quality of life.
营养不良、胆囊功能障碍、倾倒综合征、反流性食管炎及残胃炎是胃切除患者术后不良的后遗症。应改进手术方式以确保此类患者有满意的生活质量。
对20例行保留幽门胃切除术（PPG）的早期胃癌患者和25例行传统远端胃切除术（CDG）的患者术后的胆囊功能、反流性胃炎、胃排空及热量摄入进行评估。
CDG术后静息胆囊面积显著增加。相比之下，PPG术后胆囊面积无显著变化，收缩率略有下降。CDG术后，进食后最初30分钟胃排空更快。虽然PPG术后早期观察到胃排空延迟，但排空率随时间增加。PPG患者的胃pH值较低，胃黏膜损伤较轻。这些结果归因于幽门功能的保留。CDG组和PPG组术后热量摄入及体重变化相似。
PPG在胆囊功能、残胃状况及胃排空方面优于CDG，对于精心挑选的早期胃癌患者应采用PPG以改善其生活质量。
